Covid19

[Too Tall]

I read Robot Check a few years ago. Worth a read, imo.

There was a chapter where the doc goes into some math comparing deaths in Liberia from ebola to deaths from measles at the same time. What I recall (of course, his delivery and expertise put me to shame) is that each Ebola infection leads to few subsequent infections, but the odds of dying from infection are very high. In contrast, each measles infection leads to many infections but the odds of death are very low. With the near total shut down of the Liberian health sector and the strong emphasis on Ebola isolation, he estimated that more people died from relatively unchecked measles in Liberia than died from Ebola in the epidemic period.

Eggzactly. Turns out if you provide decent training, supportive care, antibiotics, a smidge of investigation and wee followup most infected patients recover and clusters go away. Presently, I think the most dangerous aspect of EBOLA is weaponizing by not allowing external support org.s into (fill in the blank at war countries) where there are outbreaks. But that's another story.

[DaveS]

Eggzactly. Turns out if you provide decent training, supportive care, antibiotics, a smidge of investigation and wee followup most infected patients recover and clusters go away. Presently, I think the most dangerous aspect of EBOLA is weaponizing by not allowing external support org.s into (fill in the blank at war countries) where there are outbreaks. But that's another story.

I agree with your comment, but also want to note that there are additional complicating factors including lack of sensitive and specific rapid diagnostics and the fact that during early stages of infection the symptoms look very similar to other diseases that are endemic to the area (malaria for instance). This can make it challenging to determine who should be isolated and receive supportive care, vs., e.g. being sent home with a course of anti-malarials.

[megapope]

i do suspect classes may end up being cancelled & everyone sent home from my university if this hits big.

in that case i'll be loading up the carradice and setting out somewhere. taking advantage of any dip in road travel, you know, and you can't catch it if you're out on the road by yourself breathing fresh clean air.

[Bobonli]

Argh. The flu is worse in terms of kill rate, but Covid has a better advertising agency: the News Media!

CNN had some pretty good coverage. Viruses succeed by NOT killing their host, so the unfortunate people who die very often have some co-morbidities that make them more vulnerable than the average person. My understanding is that Covid is following much the same path as the flu in terms of who is dying. One epidemiologist quoted by CNN said we should be prepared to change our vernacular from "Cold and Flu season" to "Cold, flu and Covid season."

Working in an ED back in the late 80's, we all thought for sure that AIDS would wipe out large chunks of the population. It didn't. We fear things we don't understand and our understanding is not helped my the current media climate of bold headlines, pictures of people wearing feminine hygiene pads as face masks, and other click-bate.

[Will Neide]

Argh. The flu is worse in terms of kill rate, but Covid has a better advertising agency: the News Media!

CNN had some pretty good coverage. Viruses succeed by NOT killing their host, so the unfortunate people who die very often have some co-morbidities that make them more vulnerable than the average person. My understanding is that Covid is following much the same path as the flu in terms of who is dying. One epidemiologist quoted by CNN said we should be prepared to change our vernacular from "Cold and Flu season" to "Cold, flu and Covid season."

We, lab folks, just call it respiratory season.

Or, I guess you could call it "Flu A, Flu B, Paraflu, Metapneumo, Corona, Adeno, Rhino/Entero, RSV, B. parapertussis, B. pertussis, C. pneumonia, M. pneumoniae season." Just a lot of critters going around.

Wash your hands people!

[Too Tall]

i do suspect classes may end up being cancelled & everyone sent home from my university if this hits big.

in that case i'll be loading up the carradice and setting out somewhere. taking advantage of any dip in road travel, you know, and you can't catch it if you're out on the road by yourself breathing fresh clean air.

Smartest thing I've heard all day.

[guido]

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China - THE LANCET

This article suggests the mortality rate is closer to 15%...

[wmidkiff]

Coronavirus Epidemic: Updates, Spread, Symptoms, & Treatment (COVID-19) - YouTube

This series of video updates has been informative if anyone cares to burn through them. They become a bit redundant, but the physician covers some good micro and epidemiology basics in some of the earlier videos.

[caleb]

i do suspect classes may end up being cancelled & everyone sent home from my university if this hits big.

in that case i'll be loading up the carradice and setting out somewhere. taking advantage of any dip in road travel, you know, and you can't catch it if you're out on the road by yourself breathing fresh clean air.

If we were to close, it would likely overlap with our steelhead runs. I will happily go into quarantine on the river.

[robin3mj]

If we were to close, it would likely overlap with our steelhead runs. I will happily go into quarantine on the river.

Then you'd just need to watch out for corvinavirus...


Sorry, I'll just see myself out.






.

[Too Tall]

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China - THE LANCET

This article suggests the mortality rate is closer to 15%...

Typically excellent Lancet article. Thanks

[j44ke]

Two Italian staff members of one of the pro teams at the UAE Tour just tested positive for the novel corona virus, so that means quarantine for the entire race(?) That is a lot of people in pro cycling to take out of circulation. And equipment.

[pmac]

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China - THE LANCET

This article suggests the mortality rate is closer to 15%...

A couple of things to point out about this paper that are relevant to mortality rate.

1. It was published Jan 24, relying on patient data from up to Jan 2. In other words, well before much was known, and in particular, much before there was any info on the frequency of asymptomatic individuals (now known to be high, although a reliable number is still very much a work in progress). So, the group of patients is limited to those with readily identifiable symptoms, which strongly skews the sample.

2. Note the frequency of patients with an underlying disease/condition: 32%. Specifically, diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Note that these categories add up to more than 32%, meaning that some people had more than one underlying health issue.

Conclusion: the morbidity value is based on a population that does not include those with mild cases, and does include those with preexisting problems. Unless obesity is proven to be an extreme risk factor for this disease, many/most people are not in the high risk group, and the morbidity will be much lower.

That's my interpretation from reading the paper and being generally aware of what's going on but not directly working on this. My colleagues (I'm a genetics prof with an active research lab) who do work on things more directly relevant (but not necessarily on coronaviruses) keep saying to anyone who's interested that from a personal health perspective (ie, not from a 401K perspective) you should be a lot more concerned about the flu.

Paul

[SeanEasley]

Meh, bring it on. Not trying to be in-sensitive to the ~2% who will perish from this, but my livelihood now involves working with high school kids each day. I'm more concerned with the girl who is cutting herself today over a break-up and telling her friends "you won't miss me when I'm gone" or the high-flying class leading senior boy who just found out he was disqualified from military service because of medical history and is now texting things like "my plan now is homelessness or suicide".

[Blue Jays]

"...Meh, bring it on..."

The illness and death of a sibling, parent, aunt, uncle, cousin, grandparent or friend of one of those kids will not help them.
My sense is wishing for Covid19 creates bad karma and negative energy. Pray for our researchers and medical professionals.

[vertical_doug]

The illness and death of a sibling, parent, aunt, uncle, cousin, grandparent or friend of one of those kids will not help them.
My sense is wishing for Covid19 creates bad karma and negative energy. Pray for our researchers and medical professionals.

Yeap, Dr. Li Wenliang who warned of the virus, was attacked by the State for rumor spreading, and later died from infection should be given the Medal of the Republic from China. For as bad as it looks now, the Chinese just shut the door before the real Lunar New Year rush began. One week later, and the situation now would be exponentially worse.

[fastupslowdown]

Yeap, Dr. Li Wenliang who warned of the virus, was attacked by the State for rumor spreading, and later died from infection should be given the Medal of the Republic from China. For as bad as it looks now, the Chinese just shut the door before the real Lunar New Year rush began. One week later, and the situation now would be exponentially worse.

There's a gag order in place for scientists and medical professionals working for the government. They want to control the message. Any public comments or media interviews must be signed off by Trump's team which I believe is Mnuchin, Kudlow and Pence. What concerns me is the lack of transparency may cause the public to doubt the accuracy of information coming from the government and could also result in a reduction of important information to the public. We have the makings of another Wuhan response. We had a Pandemic response team at the NSC but they were all fired in 2018.

[fastupslowdown]

I see Northern Italy is now under lockdown. I got a message that they are monitoring the situation. Popular events like the Maratona are still planned but that could all change

[vertical_doug]

A couple of things to point out about this paper that are relevant to mortality rate.

1. It was published Jan 24, relying on patient data from up to Jan 2. In other words, well before much was known, and in particular, much before there was any info on the frequency of asymptomatic individuals (now known to be high, although a reliable number is still very much a work in progress). So, the group of patients is limited to those with readily identifiable symptoms, which strongly skews the sample.

2. Note the frequency of patients with an underlying disease/condition: 32%. Specifically, diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Note that these categories add up to more than 32%, meaning that some people had more than one underlying health issue.

Conclusion: the morbidity value is based on a population that does not include those with mild cases, and does include those with preexisting problems. Unless obesity is proven to be an extreme risk factor for this disease, many/most people are not in the high risk group, and the morbidity will be much lower.

That's my interpretation from reading the paper and being generally aware of what's going on but not directly working on this. My colleagues (I'm a genetics prof with an active research lab) who do work on things more directly relevant (but not necessarily on coronaviruses) keep saying to anyone who's interested that from a personal health perspective (ie, not from a 401K perspective) you should be a lot more concerned about the flu.

Paul

The White House may based decisions on economic considerations and not medical. I believe the spanish flu was made worse in England because the gov did not want to publicize it because of hurting morale for the war effort. Local doctors all had to figure out it wasn't their common flu on their own.

Japan is about to turn itself inside out in an attempt to contain the virus so not to jeopardize the Olympics and have it cancelled and lose face.

Ever since the 1970's oil shock, whenever there is a crisis, the Japanese hoard toilet paper. Don't know why. Today a Gov Minister urged Japanese not to hoard toilet paper.

[robin3mj]

Meh, bring it on. Not trying to be in-sensitive to the ~2% who will perish from this, but my livelihood now involves working with high school kids each day. I'm more concerned with the girl who is cutting herself today over a break-up and telling her friends "you won't miss me when I'm gone" or the high-flying class leading senior boy who just found out he was disqualified from military service because of medical history and is now texting things like "my plan now is homelessness or suicide".

My livelihood involves the care and housing of seniors, for whom the mortality rate of this virus (as well as the common flu) is many orders of magnitude higher than the overall population. So if this is going to be the new normal, we’ll have to learn to deal with it, but getting to there from where we’re sitting today is going to be quite rocky.